Last week, the results from a long-anticipated study on mental illness in Australia got published: the 2020-2021 National Study of Mental Health and Wellbeing from the Australian Bureau of Statistics. Before I start my plea regarding its findings, I will have a cheeky dig at its confusing name, as the study captures neither health nor wellbeing, but almost exclusively focuses on disorder. While this in itself riles me up, there are bigger fish to fry than the restricted focus of mental health studies and problematic use of language itself in mental healthcare.
What I would like to do is to provide some commentary on its findings. The results are at first glance confronting, and unsurprisingly have already stirred up a decent conversation in the media and on Internet outlets such as Twitter: everyone’s favourite platform for nuanced conversations.
The conversation and calls for reform that the study is generating are important and necessary. Not because this data has unravelled something earth shattering; something we did not already know. As a matter of fact, its findings perfectly fit a picture that data has been showing us for years now:
There has been no material improvement in the prevalence of mental illness for the past 30 years, despite increased investment and gains related to access to, and acceptability of, evidence-based treatment. On the contrary, this new data shows that we have gone backward*.
No, this conversation is necessary for the same reason as advocacy on the need for climate change is necessary. For the same reason that we need to continue to talk about reducing inequality for minority groups in society. For the same reason that we need to keep talking about improving reproductive rights. For the same reason that we need to keep talking about domestic violence.
The common thread for the above areas is a failure for real action, despite the presence of unequivocally clear data of its adverse consequences on individuals and society in general.
Good intentions of individuals, some organisations and some parts of government aside, we are failing to act adequately on data that clearly shows poor outcomes with disastrous consequences and massive costs: anyone ordered an uninhabitable hellscape for our kids in return for short-term comfort? Anyone?
Turning back to mental illness it is quite clear:
We. Are. Failing. People. Who. Need. Help.
This is not some future problem you are convincing yourself of.
No matter your vested interest in any solutions to fix the problem, this should be a thing we can all agree on.
These people aren’t some invisible people you do not know. They aren’t just statistics. They are your loved ones. Your friends. The people you work with. The people in your community.
The study shows that 43.7% of people had a disorder at one stage of their life. It is quite literally impossible for you to not to know someone who has had a diagnosable illness at some point in their life. You may not be aware of who they are, but that doesn’t make their suffering less real.
Two in five young people aged 16 – 24 have experienced a diagnosable disorder in just the last year. That’s just last year. Compare that with the previous studies by the ABS and we see a 50% increase. Take a moment to think of the people you know in this age category. Do you know five? Ten? More? Well, nearly half of them are likely to be struggling with a diagnosable condition right now.
While women seek help more than men (which is a positive), they - particularly young women - struggle much more with their mental health across all diagnoses bar substance use. It should not be acceptable that we leave these women to struggle.
Only 46.5% of people with a 12-month disorder see a health professional. What on earth are the other half doing? Why are they left unserved?
A very important note to make clear - the above does not even capture people who simply struggle without falling within a diagnosable category. This does not capture anyone who is languishing, making the problem of poor mental health far worse than portrayed in the study. Our data at Be Well Co shows the total burden of mental health problems if we include those with low wellbeing is two in three people!
I could go on and highlight many more interesting findings, which we are planning on doing in a rolling blog series on studies and data (more about that later). The crucial point for this blog is that our current approach to mental health care is failing the people who need it.
I cannot conceive of an area in life where there would not be a serious change if a solution or system fails to lead to material changes for decades. Do you think that the cancer field would not look for alternative solutions if it poured 30 years of investment into a system that failed to have an impact on cancer rates? What about other areas of high impact such as airplane or vehicle safety? Would they just continue to pour money into systems without seeing some form of improvement?
It is time for change. It is time for new approaches to mental healthcare. We cannot keep going on the way we have. What are the potential solutions or ways forward you ask? Stay tuned for this in the coming months, including why our response must include a stronger focus on mental health promotion for all people and what positive role you or your organisations can play in helping us solve this challenge.
* The study was conducted during COVID-19, which will act as a confounder, but earlier studies were showing similar findings related to prevalence rates. So yeah, that causal fallacy won’t get us off the hook.